CPT® Code 28735

Arthrodesis of the midtarsal or tarsometatarsal joints, as described by CPT® Code 28735, is a surgical procedure aimed at fusing multiple joints in the midfoot region. This procedure is typically indicated for patients suffering from severe, painful arthritis or congenital or acquired deformities that affect the midfoot's structural integrity and function. The surgery involves creating a longitudinal incision over the affected joints, ensuring that superficial nerves and blood vessels are adequately protected throughout the process. Once the joint is accessed, the surgeon meticulously removes all fibrous tissue and articular cartilage to prepare the joint surfaces for fusion. In cases of significant deformity, additional steps may include the resection of bone to achieve proper alignment and stability. The articular surfaces are then carefully scaled using an osteotome to promote optimal bone healing. If necessary, a bone graft may be harvested either locally or from donor sites such as the iliac crest or medial malleolus, shaped to fit the joint space, and placed to facilitate fusion. To ensure stability during the healing process, internal fixation devices, such as Steinmann pins, interfragmentary screws, or plates and screws, are utilized. The procedure concludes with the closure of the incisions in layers, followed by the application of a bulky dressing and splint to support the foot during recovery. It is important to note that CPT® Code 28735 is specifically used when an osteotomy is performed in conjunction with the arthrodesis, particularly for conditions like flatfoot deformity, whereas CPT® Code 28730 is designated for cases where the procedure is conducted without an osteotomy.